Table 1.
Natural course of chronic hepatitis B *.
| Phase | 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|---|
| HBeAg-positive chronic infection, also called Immune tolerant phase | HBeAg-positive chronic hepatitis, also called immune reactive phase | HBeAg-negative chronic hepatitis | HBeAg-negative chronic infection, also called inactive carrier phase | HBsAg-negative, also called resolved HBV infection or occult HBV infection a | |
| Serological marker | HBeAg (+); Anti-HBe (−) |
HBeAg (+); may develop anti-HBe |
HBeAg (−); Anti-HBe (+/−) |
HBeAg (−); Anti-HBe (+) |
HBsAg (−); Anti-HBc (+) a; Anti-HBs (+/−) |
| HBV DNA | very high levels, generally ≥107 IU/mL | 104–107 IU/mL | >2000 IU/mL | Generally <2000 IU/mL or negative | <200 IU/mL or negative |
| ALT | Normal | Elevated | Elevated | Normal | Normal |
| Liver disease | None/Minimal | Moderate/severe | Moderate/severe | None/minimal | None |
* Reference: [2,3]. a: Occult Hepatitis B virus (HBV) infection (OBI) can be defined as the long-lasting persistence of viral genomes in the liver tissue (and in some cases also in the serum) [4]. Based on HBV specific antibodies, there are two groups of OBI: seropositive OBI: anti-HBcAb and/or anti-HBsAb positive; seronegative OBI: anti-HBcAb and anti-HBsAb-negative [5].